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Diabetes and the Kidneys (Nephropathy)

Diabetes is now the leading cause of kidney failure in North America, having surpassed high blood pressure in the late 1980s. One of the main reasons for controlling blood sugars well is to avoid this dreaded complication and its need for dialysis.

By the time you develop symptoms of kidney disease, it is much too late to save your kidneys - they will fail and you eventually need dialysis. Therefore, your doctor will do some blood and urine tests looking for early signs of kidney deterioration. These lab tests show up abnormalities before any symptoms develop.

Your doctor should test your urine for microalbumin (micro: or very small amounts; and albumin: a type of protein), using highly sensitive tests. An elevated level of microalbumin is detectable before any other change in the kidney, making this test extremely important. When caught at this early stage, kidney disease may be slowed or even halted by medication.

Furthermore, this test is a good indicator of changes to the blood vessel (artery) wall, especially in the Type 2 diabetic. It is therefore a strong predictor of hardening of the arteries. If urine microalbumin is abnormal, the chances of heart attack or stroke are vastly increased. All other risk factors for heart disease must be therefore be corrected aggressively, including lipids, smoking and blood pressure.


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